current diabetes research

About the Journal

Diabetes publishes original research about the physiology and pathophysiology of diabetes mellitus. Submitted manuscripts can report any aspect of laboratory, animal, or human research. More About Diabetes

Editor in Chief

David A. D'Alessio, MD Duke University

Impact Factor

Journal Statistics

Current Issue Highlights

The Longitudinal Effect of Diabetes-Associated Variation in TCF7L2 on Islet Function in Humans

Trefoil Factor 2 Expressed by the Murine Pancreatic Acinar Cells Is Required for the Development of Islets and for β-Cell Function During Aging

Increased Thalamocortical Functional Connectivity on Discontinuation of Treatment in Painful Diabetic Peripheral Neuropathy

The Role of Activator Protein-1 Complex in Diabetes-Associated Atherosclerosis: Insights From Single-Cell RNA Sequencing

Access the complete Table of Contents .

Follow Diabetes on X  

Join us on X  @Diabetes_ADA to connect with the diabetes research community and share ideas with fellow professionals. Find the newest published articles, latest podcasts, new professional books, and up-to-date diabetes news. You can also follow ADA Publications on Facebook @adaPublications .

New Podcast: DiabetesBio

DiabetesBio, the American Diabetes Association's monthly podcast, features Drs. Kirk Habegger, Darleen Sandoval, and Kevin Williams interviewing authors of key articles from the journal Diabetes .

Paper of the Month

Each month, the Editors of Diabetes  select an original research article to designate Paper of the Month. View these exclusive articles in a freely accessible special article collection.

Pathway to Stop Diabetes

The ADA vision: find a new generation of scientists at the peak of their creativity and provide them the freedom, autonomy, and financial and professional resources for breakthrough discoveries.

• Online ISSN 1939-327X
• Print ISSN 0012-1797
• Diabetes Care
• Clinical Diabetes
• Diabetes Spectrum
• Standards of Medical Care in Diabetes
• Scientific Sessions Abstracts
• BMJ Open Diabetes Research & Care
• ShopDiabetes.org
• ADA Professional Books

Clinical Compendia

• Clinical Compendia Home
• Latest News
• DiabetesPro SmartBrief
• Special Collections
• DiabetesPro®
• Diabetes Food Hub™
• Insulin Affordability
• Know Diabetes By Heart™
• About the ADA
• Journal Policies
• For Reviewers
• Advertising in ADA Journals
• Reprints and Permission for Reuse
• Copyright Notice/Public Access Policy
• ADA Professional Membership
• ADA Member Directory
• Diabetes.org
• X (Twitter)
• Cookie Policy
• Accessibility
• Terms & Conditions
• Get Adobe Acrobat Reader
• © Copyright American Diabetes Association

This Feature Is Available To Subscribers Only

Sign In or Create an Account

• Weill Cornell Medicine

New Study Reveals Promising Findings to Treat Type 2 Diabetes

A new  study   published in the   Journal of Clinical Investigation  has demonstrated that activating a pathway to promote cell division not only expanded the population of insulin-producing cells, but, surprisingly, also enhanced the cells’ function.  The findings hold promise for future therapeutics that will improve the lives of individuals with type 2 diabetes—a condition that affects more than half a billion people worldwide.

Dr. Laura Alonso

“That’s reassuring because there is a long-standing belief in the field that proliferation can lead to ‘de-differentiation’ and a loss of cell function,” said study senior author   Dr. Laura Alonso , chief of the division of endocrinology, diabetes and metabolism, director of the   Weill Center for Metabolic Health , and the E. Hugh Luckey Distinguished Professor in Medicine at Weill Cornell Medicine. “Our result flies in the face of that dogma and suggests if we can find a way to trigger replication of the beta cells in the body, we won’t impair their ability to produce and secrete insulin.”

First author, Rachel Stamateris, also contributed to this work as an MD, PhD student at the University of Massachusetts Medical School and visiting graduate assistant in medicine at Weill Cornell Medicine.

When Beta Cells Fail

In type 2 diabetes, the body’s tissues become resistant to insulin, which means they can’t take in and use blood sugar. At the same time, insulin-producing beta cells in the pancreas fail—diminishing in number and losing their ability to function.

Dr. Alonso and her colleagues reproduced these conditions in a mouse model of diabetes that lacks IRS2, a protein that allows insulin to transmit its signal for cells to absorb blood sugar. These mice displayed insulin resistance, a seminal feature of human type 2 diabetes. “On top of that,” said Dr. Alonso, “the IRS2 protein also turns out to be critical for beta cell function and beta cell number.” So, their pool of beta cells was depleted.

The first order of business to rescue these mice: boost beta cell numbers. But how? She and her team took a closer look at the molecular machinery that controls cell proliferation. The researchers observed that in the IRS-deficient diabetic mice, beta cells failed to elevate production of cyclin D2. This protein, when partnered with a protein called CDK4, drives cell division. Previous studies had shown that mice lacking CDK4 also develop diabetes.

It seemed logical to test if boosting CDK4 activity would help increase beta cell quantity. When Dr. Alonso’s team genetically introduced an active form of CDK4 into the diabetic mice that was more available to attach to cyclin D2, the first thing they noticed was the animals’ blood sugars were restored to normal. Their beta cells were more plentiful than in the untreated, IRS2 mutant mice. But even better: “The beta cells looked amazingly healthy in the treated mice compared with the original diabetic mice, whose beta cells look terrible. Increasing the activity of CDK4 resulted in beta cells packed full of insulin,” said Dr. Alonso, who is also an endocrinologist at NewYork-Presbyterian/Weill Cornell Medical Center.

This supports the concept that beta cell mass can be expanded without compromising function.

While CDK4 is not, itself, a viable therapeutic target because its ability to stimulate proliferation could increase the risk of cancer, Dr. Alonso is confident that probing the molecular pathways that govern beta cell division and function could someday lead to a clinical breakthrough. She pointed to Ozempic, one of the most talked about new treatments for diabetes. “That medication was discovered by a scientist studying toxins in the saliva of the Gila monster,” said Dr. Alonso. “So, it’s clear that understanding how fundamental biology works can lead to real advances in treating or even preventing diabetes.”

Many Weill Cornell Medicine physicians and scientists maintain relationships and collaborate with external organizations to foster scientific innovation and provide expert guidance. The institution makes these disclosures public to ensure transparency. For this information, see the profile for Dr. Laura Alonso .

This study was supported by grants K08DK076562, R01DK095140, R01DK124906, and R01DK114686 from the National Institute of Diabetes and Digestive and Kidney Diseases.

Releated Links: Boosting Beta Cells to Treat Type 2 Diabetes

Back to News

• Endocrinology, Diabetes & Metabolism

Current Diabetes Reports

• Roopa Mehta

Latest issue

Volume 24, Issue 11

Latest articles

Gestational diabetes mellitus and subsequent risks of diabetes and cardiovascular diseases: the life course perspective and implications of racial disparities.

Precision Interventions Targeting the Maternal Metabolic Milieu for Healthy Pregnancies in Obesity

• Alexandra M. Niclou
• Hannah E. Cabre
• Leanne M. Redman

Napping and Obesity in Adults – What do we Know?

• Sasiwarang Goya Wannamethee

Are we Ready for Real-Time Continuous Glucose Monitoring in the Hospital Setting? Benefits, Challenges, and Practical Approaches for Implementation

• Athena Philis-Tsimikas
• Emily Rose N. San Diego
• Cora Singleton

Lifestyle Intervention in Reducing Insulin Resistance and Preventing type 2 Diabetes in Asia Pacific Region: A Systematic Review and Meta-Analysis

• Yingting Cao
• Abha Shrestha
• Tilahun Haregu

Journal updates

Covid-19 and impact on peer review.

As a result of the significant disruption that is being caused by the COVID-19 pandemic we are very aware that many researchers will have difficulty in meeting the timelines associated with our peer review process during normal times.  Please do let us know if you need additional time. Our systems will continue to remind you of the original timelines but we intend to be highly flexible at this time.

Journal information

• CAB Abstracts
• Chemical Abstracts Service (CAS)
• Current Contents/Clinical Medicine
• Google Scholar
• Japanese Science and Technology Agency (JST)
• OCLC WorldCat Discovery Service
• Science Citation Index Expanded (SCIE)
• Semantic Scholar
• TD Net Discovery Service
• UGC-CARE List (India)

Rights and permissions

Editorial policies

© Springer Science+Business Media, LLC, part of Springer Nature

• Find a journal
• Publish with us
• Track your research

An official website of the United States government

Here’s how you know

Official websites use .gov A .gov website belongs to an official government organization in the United States.

Secure .gov websites use HTTPS A lock ( Lock Locked padlock icon ) or https:// means you’ve safely connected to the .gov website. Share sensitive information only on official, secure websites.

• Entire Site
• Research & Funding
• Health Information
• About NIDDK
• Research Areas

Diabetes affects an estimated 38.4 million people in the United States and is the eighth leading cause of death.  Diabetes is characterized by the body’s inability to produce and/or respond appropriately to insulin.  These defects result in persistent elevation of blood glucose levels and other metabolic abnormalities, which in turn lead to the development of disease complications, such as heart disease and stroke, blindness, kidney failure, and lower limb amputation. In addition to increasing the risk for these complications, diabetes also doubles the risk for many forms of cancer, some forms of dementia, hearing loss, erectile dysfunction, urinary incontinence, and many other common diseases.

• Type 1 diabetes affects approximately 6 percent of adults and the majority of children and youth with diagnosed diabetes.
• Type 2 diabetes is the most common form of the disease, accounting for about 90 to 94 percent of diagnosed diabetes cases in U.S. adults. Type 2 diabetes is also increasingly being diagnosed in children and adolescents, and disproportionately affects individuals from racial and ethnic minority populations.
• Prediabetes affects an estimated 97.6 million adults in the United States. Individuals with prediabetes are at high risk of developing type 2 diabetes.
• Gestational diabetes affects a significant proportion of pregnant persons. In addition to placing the pregnant person and their child at risk for complications during childbirth, gestational diabetes increases their future risk for type 2 diabetes.

The NIDDK supports basic, clinical, and translational research to combat diabetes and its associated complications. For example, NIDDK-supported researchers are:

• studying genetic and environmental factors that contribute to the development and progression of diabetes;
• identifying ways to improve diabetes health equity and reduce diabetes health disparities ;
• studying ways to preserve insulin-producing cells of the pancreas;
• identifying new methods to improve blood glucose monitoring and insulin delivery in type 1 diabetes;
• examining behavioral approaches to prevent type 2 diabetes and to enhance diabetes self-management;
• conducting clinical trials testing new prevention and treatment strategies for diabetes and its complications; and
• uncovering the fundamental cellular and molecular pathways underlying development of diabetes and its complications to develop new and more personalized approaches to prevention and management.

The NIDDK also administers the Special Statutory Funding Program for Type 1 Diabetes Research, which is a special appropriation dedicated to supporting research on type 1 diabetes and its complications. More information on the Program and the research it supports is available on the Type 1 Diabetes Research Special Statutory Funding Program website .

In addition, NIDDK has congressional authorization for the National Diabetes Information Clearinghouse , which provides services via the NIDDK Health Information Center. NIDDK responds to questions and provides health information about diabetes to people with diabetes and to their families, health professionals, and the public.

Research Updates and News

• Bariatric surgery provides long-term blood glucose control, type 2 diabetes remission
• Celebrating the 50th Anniversary of Diabetes Research Centers
• Diabetes in America now available
• Islet Transplantation for Treating Difficult-to-Manage Type 1 Diabetes in Adults
• The Special Diabetes Program: 25 Years of Advancing Type 1 Diabetes Research

View More News Items

Select Landmark Studies

• Diabetes Prevention Program (DPP)
• Blood Glucose Control Studies for Type 1 Diabetes: DCCT and EDIC

To achieve its mission, NIDDK supports, conducts, coordinates, and plans research. NIDDK also provides data and samples from NIDDK-funded studies and explains research findings to health professionals and the public.

Support Research

NIDDK invests in basic, clinical and translational research and training at colleges, universities and other institutions.

• Bioengineering, Biotechnology, and Imaging as applied to Diabetes, Metabolic, and Endocrine Diseases
• Clinical Research in Type 1 Diabetes
• Clinical Research in Type 2 Diabetes
• Diabetes and Metabolism HIV/AIDS
• Diabetes Genetics and Genomics
• Diabetes, Endocrine, and Metabolic Disease Translational Research
• Diabetes: Treatment, Prevention, and Complications

Conduct Research

NIDDK investigators conduct biomedical research and training in the Institute's laboratories and clinical facilities in Maryland and Arizona.

• Diabetes, Endocrinology, and Obesity Branch
• Laboratory of Biochemistry and Genetics
• Laboratory of Biological Modeling
• Laboratory of Bioorganic Chemistry
• Laboratory of Cell and Molecular Biology

Coordinate & Plan Research

NIDDK takes multiple approaches to research planning and priority setting.

Meetings & Workshops

• NMRI South Region Workshop 2024

Strategic Plans & Reports

• Diabetes in America
• NIDDK Strategic Plan for Research
• Diabetes in America, 3rd Edition
• Special Statutory Funding Program for Type 1 Diabetes Research: Progress Report
• Special Statutory Funding Program for Type 1 Diabetes Research: Evaluation Report

Provide Access to Research Resources

NIDDK makes publicly supported resources, data sets, and studies available to researchers.

Provide Health Information

NIDDK provides patient education information, practice tools for diagnosis and treatment, and statistics.

• Diabetes Statistics
• Health Information about Diabetes
• Diabetes Discoveries & Practice Blog
• Diabetes for Health Professionals
• Advanced Health Information Search

Featured Topics

Featured series.

A series of random questions answered by Harvard experts.

Explore the Gazette

Read the latest.

Eat this. Take that. Get skinny. Trust us.

High doses of Adderall may increase psychosis risk

Breakthrough technique may help speed understanding, treatment of MD, ALS

“When my son was diagnosed [with Type 1], I knew nothing about diabetes. I changed my research focus, thinking, as any parent would, ‘What am I going to do about this?’” says Douglas Melton.

Kris Snibbe/Harvard Staff Photographer

Breakthrough within reach for diabetes scientist and patients nearest to his heart

Harvard Correspondent

100 years after discovery of insulin, replacement therapy represents ‘a new kind of medicine,’ says Stem Cell Institute co-director Douglas Melton, whose children inspired his research

When Vertex Pharmaceuticals announced last month that its investigational stem-cell-derived replacement therapy was, in conjunction with immunosuppressive therapy, helping the first patient in a Phase 1/2 clinical trial robustly reproduce his or her own fully differentiated pancreatic islet cells, the cells that produce insulin, the news was hailed as a potential breakthrough for the treatment of Type 1 diabetes. For Harvard Stem Cell Institute Co-Director and Xander University Professor Douglas Melton, whose lab pioneered the science behind the therapy, the trial marked the most recent turning point in a decades-long effort to understand and treat the disease. In a conversation with the Gazette, Melton discussed the science behind the advance, the challenges ahead, and the personal side of his research. The interview was edited for clarity and length.

Douglas Melton

GAZETTE: What is the significance of the Vertex trial?

MELTON: The first major change in the treatment of Type 1 diabetes was probably the discovery of insulin in 1920. Now it’s 100 years later and if this works, it’s going to change the medical treatment for people with diabetes. Instead of injecting insulin, patients will get cells that will be their own insulin factories. It’s a new kind of medicine.

GAZETTE: Would you walk us through the approach?

MELTON: Nearly two decades ago we had the idea that we could use embryonic stem cells to make functional pancreatic islets for diabetics. When we first started, we had to try to figure out how the islets in a person’s pancreas replenished. Blood, for example, is replenished routinely by a blood stem cell. So, if you go give blood at a blood drive, your body makes more blood. But we showed in mice that that is not true for the pancreatic islets. Once they’re removed or killed, the adult body has no capacity to make new ones.

So the first important “a-ha” moment was to demonstrate that there was no capacity in an adult to make new islets. That moved us to another source of new material: stem cells. The next important thing, after we overcame the political issues surrounding the use of embryonic stem cells, was to ask: Can we direct the differentiation of stem cells and make them become beta cells? That problem took much longer than I expected — I told my wife it would take five years, but it took closer to 15. The project benefited enormously from undergraduates, graduate students, and postdocs. None of them were here for 15 years of course, but they all worked on different steps.

GAZETTE: What role did the Harvard Stem Cell Institute play?

MELTON: This work absolutely could not have been done using conventional support from the National Institutes of Health. First of all, NIH grants came with severe restrictions and secondly, a long-term project like this doesn’t easily map to the initial grant support they give for a one- to three-year project. I am forever grateful and feel fortunate to have been at a private institution where philanthropy, through the HSCI, wasn’t just helpful, it made all the difference.

I am exceptionally grateful as well to former Harvard President Larry Summers and Steve Hyman, director of the Stanley Center for Psychiatric Research at the Broad Institute, who supported the creation of the HSCI, which was formed specifically with the idea to explore the potential of pluripotency stem cells for discovering questions about how development works, how cells are made in our body, and hopefully for finding new treatments or cures for disease. This may be one of the first examples where it’s come to fruition. At the time, the use of embryonic stem cells was quite controversial, and Steve and Larry said that this was precisely the kind of science they wanted to support.

GAZETTE: You were fundamental in starting the Department of Stem Cell and Regenerative Biology. Can you tell us about that?

MELTON: David Scadden and I helped start the department, which lives in two Schools: Harvard Medical School and the Faculty of Arts and Science. This speaks to the unusual formation and intention of the department. I’ve talked a lot about diabetes and islets, but think about all the other tissues and diseases that people suffer from. There are faculty and students in the department working on the heart, nerves, muscle, brain, and other tissues — on all aspects of how the development of a cell and a tissue affects who we are and the course of disease. The department is an exciting one because it’s exploring experimental questions such as: How do you regenerate a limb? The department was founded with the idea that not only should you ask and answer questions about nature, but that one can do so with the intention that the results lead to new treatments for disease. It is a kind of applied biology department.

GAZETTE: This pancreatic islet work was patented by Harvard and then licensed to your biotech company, Semma, which was acquired by Vertex. Can you explain how this reflects your personal connection to the research?

MELTON: Semma is named for my two children, Sam and Emma. Both are now adults, and both have Type 1 diabetes. My son was 6 months old when he was diagnosed. And that’s when I changed my research plan. And my daughter, who’s four years older than my son, became diabetic about 10 years later, when she was 14.

When my son was diagnosed, I knew nothing about diabetes and had been working on how frogs develop. I changed my research focus, thinking, as any parent would, “What am I going to do about this?” Again, I come back to the flexibility of Harvard. Nobody said, “Why are you changing your research plan?”

GAZETTE: What’s next?

MELTON: The stem-cell-derived replacement therapy cells that have been put into this first patient were provided with a class of drugs called immunosuppressants, which depress the patient’s immune system. They have to do this because these cells were not taken from that patient, and so they are not recognized as “self.” Without immunosuppressants, they would be rejected. We want to find a way to make cells by genetic engineering that are not recognized as foreign.

I think this is a solvable problem. Why? When a woman has a baby, that baby has two sets of genes. It has genes from the egg, from the mother, which would be recognized as “self,” but it also has genes from the father, which would be “non-self.” Why does the mother’s body not reject the fetus? If we can figure that out, it will help inform our thinking about what genes to change in our stem cell-derived islets so that they could go into any person. This would be relevant not just to diabetes, but to any cells you wanted to transplant for liver or even heart transplants. It could mean no longer having to worry about immunosuppression.

Share this article

You might like.

Popularity of newest diet drugs fuel ‘dumpster fire’ of risky knock-offs, questionable supplements, food products, experts warn

Among those who take prescription amphetamines, 81% of cases of psychosis or mania could have been eliminated if they were not on the high dose, findings suggest

3D organoid system can generate millions of adult skeletal-muscle stem cells

Harvard releases race data for Class of 2028

Cohort is first to be impacted by Supreme Court’s admissions ruling

Parkinson’s may take a ‘gut-first’ path

Damage to upper GI lining linked to future risk of Parkinson’s disease, says new study

A .gov website belongs to an official government organization in the United States.

A lock ( ) or https:// means you've safely connected to the .gov website. Share sensitive information only on official, secure websites.

• Risk Factors
• Providing Care
• Living with Diabetes
• Clinical Guidance
• DSMES for Health Care Providers
• Prevent Type 2 Diabetes: Talking to Your Patients About Lifestyle Change
• Employers and Insurers
• Community-based Organizations (CBOs)
• Toolkits for Diabetes Educators and Community Health Workers
• National Diabetes Statistics Report
• Reports and Publications
• Data and Statistics
• Current Research Projects

Related Topics:

• View All Home
• National Diabetes Prevention Program
• State, Local, and National Partner Diabetes Programs for Public Health
• Diabetes Self-Management Education and Support (DSMES) Toolkit
• About the Division of Diabetes Translation

Research Summaries

Keep up with CDC's latest diabetes and diabetes-related studies with these brief overviews. Each summary provides main points, methods, and findings and includes a link to the article.

Research summaries

How People with Type 2 Diabetes Can Live Longer

Diabetes Education Linked to Better Care

Treatments for Diabetes Eye Complications

Mental Health for Kids and Teens With Diabetes

Cost of Diabetes Complications for Medicare Beneficiaries

Diabetes in Young People Is on the Rise

Additional 12 Million US Adults Eligible for Diabetes Screening

Trends in Diabetes Among Young People

Use of New Diabetes Medicines

Kidney Failure and Diabetes

Diabetes is a chronic disease that affects how your body turns food into energy. About 1 in 10 Americans has diabetes.

For Everyone

Health care providers, public health.

An official website of the United States government

The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

• Publications
• Account settings

The PMC website is updating on October 15, 2024. Learn More or Try it out now .

• Advanced Search
• Journal List
• Popul Health Manag

Diabetes 2030: Insights from Yesterday, Today, and Future Trends

William r. rowley.

1 Institute for Alternative Futures, Alexandria, Virginia.

Clement Bezold

Yasemin arikan.

2 Public Affairs Strategy, Novo Nordisk Inc., Plainsboro, New Jersey.

Shannon Krohe

3 Novo Nordisk Inc., Washington, District of Columbia.

To forecast future trends in diabetes prevalence, morbidity, and costs in the United States, the Institute for Alternative Futures has updated its diabetes forecasting model and extended its projections to 2030 for the nation, all states, and several metropolitan areas. This paper describes the methodology and data sources for these diabetes forecasts and discusses key implications. In short, diabetes will remain a major health crisis in America, in spite of medical advances and prevention efforts. The prevalence of diabetes (type 2 diabetes and type 1 diabetes) will increase by 54% to more than 54.9 million Americans between 2015 and 2030; annual deaths attributed to diabetes will climb by 38% to 385,800; and total annual medical and societal costs related to diabetes will increase 53% to more than $622 billion by 2030. Improvements in management reducing the annual incidence of morbidities and premature deaths related to diabetes over this time period will result in diabetes patients living longer, but requiring many years of comprehensive management of multiple chronic diseases, resulting in dramatically increased costs. Aggressive population health measures, including increased availability of diabetes prevention programs, could help millions of adults prevent or delay the progression to type 2 diabetes, thereby helping turn around these dire projections.

Introduction

D iabetes and its complications , deaths, and societal costs have a huge and rapidly growing impact on the United States. Between 1990 and 2010 the number of people living with diabetes tripled and the number of new cases annually (incidence) doubled. 1 Adults with diabetes have a 50% higher risk of death from any cause than adults without diabetes, in addition to risk for myriad complications. 2 Reducing this burden will require efforts on many fronts—from appropriate medical care to significant public health efforts and individual behavior change across the nation, through state- and community-specific efforts. Public awareness is a key first step. For this purpose, the Centers for Disease Control and Prevention (CDC) releases national diabetes statistics every 2 years, providing a point-in-time picture of diabetes for the country as a whole. However, state and metropolitan diabetes forecasts with projections several years into the future also are useful as health professionals and decision makers contemplate actions to address the diabetes epidemic. Therefore, the Institute for Alternative Futures (IAF) has prepared 2015, 2020, 2025, and 2030 diabetes forecasts for the entire United States, every state, and several metropolitan statistical areas, all of which are easily accessible on the Internet. 3

This study shows how past trends, current data, and future projections provide valuable insights about the possible course of diabetes.

Prevalence of prediabetes, undiagnosed diabetes, and diagnosed diabetes

The IAF Diabetes 2030 Model utilizes many features of the previous 2025 Model that were updated based on new diabetes data trends. 4 Estimates of diagnosed diabetes prevalence to 2030 are derived from Boyle et al's sophisticated dynamic modeling paper, which projected the diabetes burden to 2050. 5 The present study utilized Boyle et al's conservative 3-state dynamic model, middle-ground scenario of low, steady diabetes incidence (8.4 cases per 1000 adult population) and low diabetes mortality. However, 2 recent studies suggest that the diagnosed diabetes incidence trend has begun to level off and could be declining. 6 , 7 It is difficult to know if this trend will continue, and hard to forecast to what extent long-term prevalence might be reduced because so many other factors, such as an aging population and falling diabetes morbidity and mortality, enter into the equation. Because the incidence used in Boyle et al's model is higher than present experience, the research team reduced its prevalence growth to 2030 by a modest 2% to prevent overestimating the magnitude of diagnosed diabetes.

The team made 2 other significant changes. Their 2025 Model utilized Boyle et al's projection that undiagnosed diabetes would be 33% of total diabetes in 2015, declining to 25% in 2030. Based on the trend of CDC national diabetes statistics (29.8% of total diabetes being undiagnosed in 2005, 24.2% in 2007, 27.1% in 2010, and 27.8% in 2012), 2 , 8 , 9 , 10 the IAF model projects 27% will be undiagnosed in 2015, declining to 24% in 2030. Second, the prevalence of prediabetes has been progressively climbing in CDC national statistics (20% of the adult population in 2000, 26% in 2007, 35% in 2010, and 37% in 2012), so the IAF model used 38% of the population ages 20 years and older having prediabetes in 2015, slowly increasing to 40% in 2030.

Each state and metropolitan area has its unique prevalence rates. Based on the latest CDC data, Dall et al calculated the prevalence of diagnosed, undiagnosed, and prediabetes for every state for 2012. 11 Utilizing the ratio of each state to US prevalence rates and assuming this rate remains constant between 2015 and 2030 (there are no data available to estimate a state's future variation), state diagnosed, undiagnosed, and prediabetes forecasts were created. Metropolitan area forecasts utilized their state prevalence rates.

Population data

The national census data (including race and Hispanic origin) population projections to 2030 came from 2010 US Census Bureau data. 12 Unfortunately, state projections have not been updated with the 2010 census so 2000 census data were used. 13 Census data of state minority projections to 2025 were last calculated from the 1990 census, and most states do not have their own projections to 2030. The research team therefore considered state minority forecasts too imprecise to include them in the IAF Diabetes 2030 Model. Metropolitan statistical area population projections to 2030 came from Demographia 14 and Bizjournals. 15

Diabetes morbidity and mortality

The CDC National Center for Health Statistics tracks visual impairment, 16 end-stage renal failure, 17 and lower extremity amputation 18 annual trends related to diabetes. Analysis of the latest available 10-year data revealed a 19% decline in the prevalence of reported visual impairment in those with diagnosed diabetes, a 26% decline in the annual incidence of new end-stage renal failure, and a 65% decline in the incidence of nontraumatic lower extremity amputations. An additional 30% decline over the 20-year period from 2010 to 2030 for each morbidity was factored in as a plausible estimate to account for anticipated increasing access and more aggressive medical management. Each minority group had different morbidity trends, which were similarly calculated and applied for total US minority projections.

To calculate the percent risk of death from diabetes, the research team used annual death data published for the most recent 10 years (2000 to 2010) from the National Vital Statistic Reports. 19 A death from diabetes is defined as a death for which the underlying cause listed on the death certificate is diabetes. Plotting this trend line of annual percent incidence of death per individual with diagnosed diabetes revealed a 40% decline. The model assumes a modest additional 25% decline over the period between 2010 and 2030 to calculate deaths caused by diagnosed diabetes. Recent CDC diabetes fact sheets also include deaths for which diabetes was a contributing cause of death on the certificate. For instance, the latest data from 2010 state 69,071 death certificates listed diabetes as the cause and 234,051 death certificates listed diabetes as a contributing cause of death (almost 3.4 times higher). 2 Therefore, the projected declining percentage of those with diagnosed diabetes dying per year directly because of diabetes times this ratio provides the total number of annual deaths to which diabetes contributed. Specific death rate trends for minorities and seniors ages 65 and older also are derived from the National Vital Statistics Reports data.

The cost of diabetes

The 2014 paper by Dall et al calculated the direct medical costs and indirect economic burden of diagnosed diabetes, undiagnosed diabetes, and prediabetes for the United States and all states in 2012. 11 The research team adjusted these costs on a per person basis to 2015 dollars, and used them when projecting costs out to 2030 for the United States, all states, and selected metropolitan statistical areas.

Between 2015 and 2030, the IAF Diabetes Model projects that the total number of people with type 2 and type 1 diabetes will increase by 19,629,000 to 54,913,000 people, a 54% increase. The cost of diabetes in 2015 dollars will increase to $622.3 billion, a 53% increase. Table 1 presents the data for the United States between 2015 and 2030 for the population as a whole and the 2 largest minority groups—Hispanic Americans and African Americans. National data for Asian Americans, Native Americans, and seniors ages 65 and older are available online, along with data for all 50 states and several metropolitan statistical areas. 3

US Diabetes Forecasts, 2015 to 2030

DM, diabetes mellitus.

Figure 1 shows 4 maps with the age-adjusted prevalence of total diabetes as a percent of the total population for every state in the United States between 2015 and 2030. It is clear that there is a wide disparity in prevalence rates among states. The increase in diabetes prevalence between 2015 and 2030 was less than 3% for Alaska, Colorado, and Utah, whereas it was more than 5% in Alabama, Florida, Mississippi, and West Virginia. In 2030 this model predicts that diabetes will impact 10.2% of the total population of Utah, more than 18% in Alabama, Florida, and Mississippi, and 20.5% in West Virginia.

Prevalence of total diabetes as a percent of total population for each state for 2015, 2020, 2025, and 2030 based on the Diabetes 2030 Model (age adjusted to standard population).

Comparing the results from the new Diabetes 2030 Model to IAF's prior Diabetes 2025 Model reveals that there will be 1,966,700, or 4.5%, fewer people with diagnosed diabetes in 2030. Ninety-five percent of the decline is caused by the Census Bureau reducing its 2030 population projection by 15 million in the 2010 census report compared to its 2000 forecast. 12 , 20 The remainder of the decline is related to an adjustment for the recent leveling of the incidence trend. Additionally, in the new model there will be 1,519,800, or 10.3%, fewer people with undiagnosed diabetes because of lower undiagnosed diabetes prevalence rates. Therefore, total diabetes is projected to be 3,426,500, or 5.8%, lower using the Diabetes 2030 Model. However, prevalence of prediabetes is higher in this model, resulting in 12,581,900 more individuals with prediabetes (a 13.2% increase) in 2030.

The process of exploring past and present data trends to ponder their implications for the future leads to several insights about the future course of diabetes if America remains on its present course.

The incidence of diabetes may be leveling off. Geiss showed that although diabetes incidence more than doubled from 3.2 cases per 1000 adults in 1990 to 8.8 cases per 1000 in 2008, the incidence held steady statistically in 2012 at 7.1 cases per 1000. 6 In addition, a 2014 study looking at Framingham Heart Study data found the incidence of diabetes remained steady in the 2000s in spite of rising obesity. 7 However, the just released National Health and Nutrition Examination Survey found almost 38% of American adults were obese in 2013–2014 up from almost 35% in 2011–2012, suggesting that obesity has not yet leveled off. 21 Increasing obesity may lead to increasing diabetes. 22 Therefore, it is too early to know whether the promising diabetes incidence trend toward equilibrium will continue. The IAF Diabetes 2030 Model has a steady incidence rate to prevent overestimating prevalence growth.

The annual incidence of new complications related to diabetes is declining. The present study found a 26% decline in annual incidence of new end-stage renal disease related to diabetes between 1998 and 2008, a 65% decline in incidence of nontraumatic lower extremity amputation in the population with diabetes between 1999 and 2009, and a 19% decline in prevalence of reported visual impairment in those with diagnosed diabetes between 2000 and 2010. Supplementing the data from the present study, Gregg et al showed a 68% decline in the incidence of myocardial infarctions and a 53% decline in strokes in those with diabetes, in addition to a 64% decline in deaths related to hyperglycemic crisis between 1990 and 2010. 1

The annual incidence of deaths related to diabetes is declining. The present study found a 40% decline in the incidence of deaths directly caused by diabetes on the death certificate between 2000 and 2010, and the model projects a further 25% decline between 2010 and 2030. Gregg et al found that among adults with diabetes, the cardiovascular death rate declined by 40% between 1990 and 2006 and that all-cause mortality declined by 23%. 23 The declines among those with diabetes exceeded the declines among those without diabetes, resulting in a more than 50% reduction of the excess death rates attributed to diabetes. Another 2014 article by Gregg et al calculated that the number of life years lost to diabetes diagnosed at age 40 declined from 7.7 years in 1990–1999 to 5.8 years in 2000–2011 for men and from 8.7 to 6.8 years for women. 24

Management of diabetes patients is progressively improving. Multiple studies have shown that complications can be reduced significantly with intensive control of glucose, blood pressure (BP), and lipid levels in type 2 diabetes. 25 , 26 , 27 , 28 Medical care for people with diabetes is improving. Between 1999 and 2010, the US health care system achieved modest improvement in 5 out of 6 recommended goals for diabetes care: glycosylated hemoglobin (A1c) <7.0% (7.9% improvement), BP <130/80 mmHg (11.7% improvement), low-density lipoprotein (LDL) cholesterol <100 mg/dl (20.8% improvement), and an annual foot exam (6.8% improvement). Unfortunately, no improvement was seen in annual eye exams, and nearly half of all patients failed to meet at least 1 recommended goal for diabetes care. Additionally only 14.3% met the target for all 3 tested measures (A1c, BP, and LDL cholesterol) plus were not smoking. 29 Several studies have shown poor adherence to medication regimens among patients with type 1 and type 2 diabetes. 30 A 2014 study by Li et al found that during 2011–2012 only 6.8% of privately insured, newly diagnosed adults participated in Diabetes Self-Management Education and Training within the first year after diagnosis, even though it is covered by a majority of insurance plans and is strongly recommended. 31 Because participation requires a physician referral, this highlights a huge gap between a recommended guideline and current practice.

Prevalence of total diabetes, associated major complications, and deaths are all increasing. In spite of the apparent stabilizing incidence of diabetes, the prevalence of total diabetes is projected to grow 54% from 35,644,000 to 54,913,000 between 2015 and 2030. Also during this time period, the annual number of people with diabetes with new end-stage renal disease will increase by 27,370, and the number of new amputations will increase by 13,330. The annual number of deaths to which diabetes contributed will rise by 106,630. A growing population is a factor, but all these numbers are growing faster than the population. Several other factors seem to be responsible 6 : (1) An aging population that, overall, is living longer will result in more people with diabetes as incidence increases dramatically in later life. (2) The significant decline in the incidence of deaths caused by diabetes means those with diabetes will be living longer, many with significant chronic comorbidities. (3) The increasing population of African Americans and Hispanic Americans, who are at higher risk of diabetes, also adds to increased prevalence of the disease. (4) Finally, the dramatic increase in type 2 diabetes in children and adolescents, rising from 3% of new cases of diabetes in children pre-1990s to 45% of new cases in 2005, means more young and middle-aged adults will be living with diabetes. 32

The cost of diabetes is increasing dramatically. Between 2015 and 2030 the total costs in the United States are expected to increase from $408 billion to $622 billion, a 53% increase ( Table 1 ). The cost of diagnosed diabetes increased by 41% between 2007 and 2012, but individual costs of diabetes care increased only 19% whereas national health care expenditures increased 24%. Therefore, increased prevalence, not increased cost per patient, is causing the increased economic burden of diabetes. 33 Also, between 2007 and 2012 the cost of prediabetes increased 74% to $44 billion, so the increasing prevalence of diabetes and prediabetes is the driving force behind the dramatically increasing economic burden of diabetes. 11

Between 1987 and 2011 prescription medications accounted for 55% of the per capita increase in medical spending for diabetes. 34 Prescription drug prices rose 10.9% in 2014 and again more than 10% in 2015. 35 In 2014, for the fourth year in a row, per person spending on diabetes drugs was higher than any other class of traditional drug, and fewer than half of diabetes prescriptions were for generic drugs. 36 Because new advanced diabetes drugs tend to be much more expensive than those replaced, it is quite possible that the medical costs of diabetes in 2030 will be significantly higher than the present study's projections.

Major initiatives are needed to turn around the growing diabetes epidemic

Diagnosed diabetes.

The knowledge and treatment modalities for successfully managing diabetes are well established, but success requires a collaborative team working diligently with the patient and family to achieve optimal health. There is much room for improvement in health care delivery to obtain continuous access to care, consistently attend to all risk factors and comorbidities, and to help patients succeed in compliance with medications and healthy living.

Undiagnosed diabetes

One in 4 Americans with diabetes do not know that they have it, but it can lead to life-threatening complications. 2 Current screening criteria fail to detect more than 50% of undiagnosed diabetes. 33 The recent final diabetes screening guideline from the US Preventive Services Task Force, published October 27, 2015, expands the population of adults recommended for screening from only those with hypertension (2008 guideline) to all adults ages 40 to 70 years who are overweight or obese. 37 Wide dissemination and implementation of these screening criteria, even though they are more restrictive than American Diabetes Association guidelines, should help identify a much greater percentage of those adults with undiagnosed diabetes and prediabetes.

Prediabetes

The research team forecasts that the number of Americans with prediabetes will climb from 90.6 million in 2015 to 107.7 million in 2030. This increased prevalence means 30% of all Americans and 51% of all seniors would have prediabetes. Currently only about 10% of those adults with prediabetes are aware of their condition, and without effective intervention, up to a third of them will go on to develop diabetes within 5 years. 38 Programs such as the Diabetes Prevention Program clinical trial have shown that intensive lifestyle interventions can reduce the risk of going on to develop type 2 diabetes by 58% in overweight or obese adults with prediabetes. 35

The best solution for turning around the diabetes epidemic is preventing prediabetes and its progression to diabetes in the first place. Achieving such an outcome calls for addressing underlying societal risk factors that can contribute to unhealthy lifestyles, and would require a “population-wide” approach that addresses health promotion, obesity prevention, and creates a physical, cultural, and psychological environment that supports healthy living naturally. This outcome could not be achieved by individual health providers and patients alone, but requires integrated systems of care incentivized for desired health outcomes. It also would require a political will for effective policies and commitment of the public at all levels. These strategies are mutually reinforcing and may have a greater impact if addressed at the state and local levels.

Limitations

There were several limitations in this analysis. Forecasting 15 years into the future carries the caveat: if current trends do not change. Technological advances follow a general pattern, but sometimes there can be profound and unexpected shifts. People tend to be largely resistant to change, especially health behavior change. Unexpected cultural shifts and other factors prompting change are possible. The research team has been consistent in using CDC statistics, the basic Boyle et al (CDC) 2050 projection model and the Dall et al cost model. In some cases, ideal data are not available, especially regarding minorities. In addition, excellent research from different studies at times reaches quite different conclusions. The research team has been explicit about the assumptions they have made, and have been conservative in their forecasts of future trends.

Conclusions

To support efforts at public awareness, and the work of health professionals and policy makers at many levels, the research team has updated projections out to 2030 for the United States, all 50 states, and many metropolitan areas, and made them freely available online. The team finds that in spite of medical advances and prevention efforts, diabetes presents a major health crisis in terms of prevalence, morbidity, and costs, and that this crisis will worsen significantly over the next 15 years. It is important to enhance screening, education, and support efforts at the local, state, and federal levels to appropriately screen for diabetes and prediabetes. Also, in addition to effective management for all those with diabetes, success will require aggressive efforts to identify adults with prediabetes and to intervene to help them prevent or delay the progression to type 2 diabetes in the first place. Another daunting challenge in preventing diabetes and prediabetes is changing cultural norms and societal behavior and structures in order to support healthy living. Aggressive efforts are urgently needed if we want to significantly reduce the diabetes epidemic by 2030.

Acknowledgments

The authors thank Alisa B. Schiffman, DO of Novo Nordisk, for reviewing the proposed methodology for developing the 2030 diabetes forecasts. The authors thank Jerry Franz, BA, Karin Gillespie, MBA, Megan Olsen, MPH, Edward Kimball, PhD, and Cory Gamble, DO of Novo Nordisk, for reviewing draft manuscripts.

Author Disclosure Statement

Drs. Rowley and Bezold, and Ms. Arikan, Ms. Byrne, and Ms. Krohe declared the following conflicts of interest with respect to the research, authorship, and/or publication of this article: Dr. Rowley, Dr. Bezold, and Ms. Arikan are employed by the Institute for Alternative Futures (IAF), an independent nonprofit futures institute. IAF has received grants in the past from many health care organizations and pharmaceutical industry clients for health futures work. None of the 3 authors receive any other compensation from Novo Nordisk; they have no conflict of interest issues to report. Ms. Byrne and Ms. Krohe are employees of Novo Nordisk Inc. They reviewed all drafts of the methodology, the generated diabetes data, and the manuscripts that were developed and written by Dr. Rowley, Dr. Bezold, and Ms. Arikan. They provided their suggestions.

The authors received the following financial support for this article: Funding for this study was provided by Novo Nordisk Inc.

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

• View all journals
• Explore content
• About the journal
• Publish with us
• Sign up for alerts

Diabetes articles within Nature Reviews Endocrinology

Comment | 12 September 2024

The role of DNA damage in diabetic complications

Mechanistic and clinical data indicate that DNA damage contributes to the pathogenesis and progression of diabetic complications. Thus, DNA damage and its signalling are entering the field of diabetology.

• Varun Kumar
• , Ali Önder Yildirim
•  &  Peter P. Nawroth

Review Article | 03 September 2024

Harnessing cellular therapeutics for type 1 diabetes mellitus: progress, challenges, and the road ahead

Type 1 diabetes mellitus affects 8.5 million people globally and is characterized by autoimmune destruction of pancreatic β cells. This Review discusses cell replacement therapies for T1DM and outlines the challenges and future directions

• Alessandro Grattoni
• , Gregory Korbutt
•  &  Paul de Vos

Comment | 29 August 2024

The promising potential of gene therapy for diabetes mellitus

Gene therapy holds tremendous promise for treating a wide range of hereditary and acquired diseases by delivering exogenous therapeutic nucleotide sequences into specific cells or tissues. Recent advances support the notion that gene therapy could offer a long-term cure for diabetes mellitus, something that current conventional pharmacotherapies cannot achieve.

• Stefan R. Bornstein
• , J. Fraser Wright
•  &  Charlotte Steenblock

News & Views | 22 August 2024

New insights into the regulation of GIPR signalling

Two recent studies have unravelled novel modes of glucose-dependent insulinotropic polypeptide receptor (GIPR) signalling regulation. Kizilkaya et al. characterized the effect of changes in β-arrestin 2 coupling with naturally occurring GIPR coding variants, whereas Regmi et al. investigated GIPR expression profiles and functional regulation in adipocytes.

• Yusman Manchanda
•  &  Alejandra Tomas

Research Highlight | 02 August 2024

Combination therapy increases human β-cell mass in vivo

• Olivia Tysoe

Review Article | 17 July 2024

PTH receptor signalling, osteocytes and bone disease induced by diabetes mellitus

This article reviews the role of the parathyroid hormone 1 receptor (PTH1R) pathway in bone homeostasis and of osteocytes as mechanosensors and drivers of bone remodelling. It will also discuss how the PTH1R–sclerostin axis can be harnessed for the treatment of bone disease induced by diabetes mellitus.

• Silvia Marino
•  &  Teresita Bellido

Review Article | 18 June 2024

The relationship between SARS-CoV-2 infection and type 1 diabetes mellitus

Many studies identified an increase in the incidence of type 1 diabetes mellitus (T1DM) during the COVID-19 pandemic, but other reports do not support this association. This Review addresses the issue of the involvement of SARS-CoV-2 infection in the development of T1DM using evidence from epidemiological, clinical and experimental studies.

• Cyril Debuysschere
• , Magloire Pandoua Nekoua
•  &  Didier Hober

Review Article | 06 June 2024

Diabetes mellitus in patients with acromegaly: pathophysiology, clinical challenges and management

Patients with acromegaly are commonly affected by diabetes mellitus, which occurs as a complication of growth hormone hypersecretion. This Review discusses the pathophysiology of diabetes mellitus in acromegaly and explores management options in these patients.

• Daniela Esposito
• , Cesar Luiz Boguszewski
•  &  Gudmundur Johannsson

Research Highlight | 17 April 2024

A novel system for non-invasive measurement of blood levels of glucose

Review Article | 17 April 2024

Targeting the incretin system in obesity and type 2 diabetes mellitus

This article reviews advances in incretin-based pharmacotherapy, including the latest glucagon-like peptide 1 (GLP1) receptor agonists (GLP1RAs), ‘GLP1 plus’ agents, which combine the benefits of these agonists with the activity of additional hormones, and oral GLP1RAs, which promise to extend the benefits of GLP1 therapy.

• Saleem Ansari
• , Bernard Khoo
•  &  Tricia Tan

Perspective | 08 April 2024

Continuous glucose monitoring for the routine care of type 2 diabetes mellitus

Continuous glucose monitoring (CGM) is an effective tool in the management of diabetes mellitus. This Perspective discusses the potential benefits of widespread adoption of CGM in people with type 2 diabetes mellitus at different stages of disease progression and treatment intensification.

• Ramzi A. Ajjan
• , Tadej Battelino
•  &  Samuel Seidu

Research Highlight | 02 April 2024

Metformin acts through appetite-suppressing metabolite: Lac-Phe

• Shimona Starling

Review Article | 22 March 2024

Protein tyrosine phosphatase 1B in metabolic diseases and drug development

This Review summarizes cellular processes and regulation of protein tyrosine phosphatase 1B (PTP1B), discussing evidence from in vivo preclinical and human studies. PTP1B inhibitors, which are being developed for type 2 diabetes mellitus, obesity, rare diseases (such as Rett syndrome) and some cancers, are also discussed.

• Mirela Delibegović
• , Sergio Dall’Angelo
•  &  Ruta Dekeryte

Correspondence | 21 March 2024

Slowly progressive insulin-dependent diabetes mellitus in type 1 diabetes endotype 2

• Tetsuro Kobayashi
•  &  Takashi Kadowaki

Reply to ‘Slowly progressive insulin dependent diabetes mellitus in type 1 diabetes endotype 2’

• Maria J. Redondo
•  &  Noel G. Morgan

Research Highlight | 20 March 2024

Sex differences in diabetic kidney disease explained

• Claire Greenhill

Research Highlight | 07 December 2023

Highlights from SfE BES 2023

Year in Review | 06 December 2023

Type 1 diabetes mellitus: a brave new world

One hundred years after the Nobel prize was bestowed on Banting and McLeod for the ‘discovery’ of insulin, we are again seeing major evolutions in the management of type 1 diabetes mellitus, with the prospect of achieving disease control beyond mere management now becoming real. Here, we discuss the latest, most notable developments.

• Pieter-Jan Martens
•  &  Chantal Mathieu

Research Highlight | 24 November 2023

β-cells protected from T1DM by early senescence programme

Journal Club | 20 November 2023

SGLT inhibitors: a serendipitous glycaemic tale

• Shubham Agarwal
•  &  Ildiko Lingvay

The metabolic mythos of ketones

• Jonathan Low
•  &  Kaja Falkenhain

Research Highlight | 26 October 2023

Antivirals in the treatment of new-onset T1DM

Review Article | 16 October 2023

Inter-organ crosstalk during development and progression of type 2 diabetes mellitus

Inter-organ crosstalk is increasingly understood as an important mechanism contributing to insulin resistance and β-cell failure, the key features of type 2 diabetes mellitus. This Review discusses mediators of inter-organ crosstalk in type 2 diabetes mellitus, its pathogenesis and its related complications.

• Georgia Xourafa
• , Melis Korbmacher
•  &  Michael Roden

Review Article | 02 October 2023

Diabetes mellitus in breast cancer survivors: metabolic effects of endocrine therapy

Evidence indicates an elevated risk of type 2 diabetes mellitus after breast cancer treatment, particularly for endocrine therapy. This Review outlines the evidence for adverse metabolic effects of endocrine therapies in humans. Potential mechanisms, informed by preclinical research, for the increased risk of type 2 diabetes mellitus are discussed.

• Nisha S. Thomas
• , Rebecca L. Scalzo
•  &  Elizabeth A. Wellberg

Research Highlight | 25 September 2023

GWAS gives insights into glucose regulation

Journal Club | 20 July 2023

The dark side of shift work: circadian misalignment of skeletal muscle

• Ronan Lordan

Journal Club | 10 July 2023

Is combined exercise and incretin-based therapy the way forward for weight-loss maintenance?

• Julie Abildgaard

Review Article | 19 June 2023

Heterogeneity and endotypes in type 1 diabetes mellitus

There is a growing awareness that type 1 diabetes mellitus (T1DM) is a heterogeneous disease that can be characterized into distinct endotypes. This Review discusses the evidence for endotypes in T1DM and explores the implications for clinical practice.

Research Highlight | 07 June 2023

Differences in stem cell-derived islets

Clinical Outlook | 31 May 2023

Therapeutic inertia in type 2 diabetes mellitus: a fine line between advancing and de-intensifying

Type 2 diabetes mellitus is a progressive disease requiring regular monitoring and therapeutic changes. It is important that healthcare professionals embrace both ends of the spectrum of therapeutic inertia, including appropriate advancement and de-intensification of therapies.

• Kamlesh Khunti
•  &  Alice Y. Y. Cheng

Journal Club | 26 May 2023

A mitochondrial origin for inherited diabetes mellitus

• Brandon J. Berry

Comment | 24 May 2023

Artificial intelligence in diabetes mellitus and endocrine diseases — what can we expect?

Artificial intelligence has already revolutionized various fields in medicine and research. Due to the complex and interconnected nature of the endocrine system, it is an ideal area to further exploit and maximize the potential benefits of artificial intelligence.

• Ioannis T. Oikonomakos
• , Charlotte Steenblock
•  &  Stefan R. Bornstein

News & Views | 23 May 2023

How can social jetlag affect health?

Our lives are governed by three clocks: the social clock that organizes our lives with others (local time), the biological clock that controls our physiology (circadian time) and the sun clock that defines natural light and darkness. The more misaligned these clocks are, the higher our odds of developing certain diseases. ‘Social jetlag’ quantifies the difference between local and circadian time.

• Till Roenneberg

Research Highlight | 23 May 2023

Gut microbiota influences effectiveness of anti-diabetic drug

Perspective | 22 May 2023

Insulin detection in diabetes mellitus: challenges and new prospects

An urgent need exists for technologies and devices capable of frequent and real-time insulin measurements in patients with diabetes mellitus to guide optimal insulin dosing. This Perspective discusses the advances and challenges in moving insulin assays from laboratory-based assays to frequent and continuous measurements in decentralized settings.

• , Ponnusamy Nandhakumar
•  &  Joseph Wang

Clinical Outlook | 18 May 2023

Approval of teplizumab: implications for patients

Type 1 diabetes mellitus (T1DM) can be predicted, and immune therapy can alter the progression of the disease. The FDA’s approval of teplizumab as the first disease-modifying therapy for T1DM and the first therapy aimed at delaying the clinical onset of any immune-mediated disease represents a paradigm shift in the treatment of T1DM.

• Cate Speake
•  &  Carla J. Greenbaum

Perspective | 11 May 2023

Prioritization of genes associated with type 2 diabetes mellitus for functional studies

More genetic variants associated with type 2 diabetes mellitus are being identified. This Perspective article outlines various tools and platforms that can be applied to prioritize candidate genes associated with an increased risk of disease for functional validation.

• Wei Xuan Tan
• , Xueling Sim
•  &  Adrian K. K. Teo

Review Article | 02 May 2023

Metformin: update on mechanisms of action and repurposing potential

This Review highlights the latest advances in our understanding of the mechanisms of action of metformin. Potential repurposing of metformin for other indications is also discussed.

• Marc Foretz
• , Bruno Guigas
•  &  Benoit Viollet

Research Highlight | 25 April 2023

A role for the kidney in metformin action

Research Highlight | 19 April 2023

GLP1 receptor agonists for Wolfram syndrome?

Perspective | 18 April 2023

Why does the immune system destroy pancreatic β-cells but not α-cells in type 1 diabetes?

In type 1 diabetes, the immune system destroys pancreatic β-cells but not neighbouring α-cells. Here, the authors describe the key differences between β-cells and α-cells that could account for their differential autoimmune vulnerability, and how these differences could result in the preferential endurance and survival of α-cells over β-cells.

• Decio L. Eizirik
• , Florian Szymczak
•  &  Roberto Mallone

Research Highlight | 03 April 2023

Variation in metformin pharmacokinetics

Review Article | 20 March 2023

Mammalian models of diabetes mellitus, with a focus on type 2 diabetes mellitus

Small rodents are still the most widely used animal model to study the pathophysiology of diabetes mellitus but non-rodent species can also provide valuable insights. The advantages and disadvantages of selected animal models of diabetes mellitus are outlined in this Review.

• Thomas A. Lutz

Review Article | 17 March 2023

Revisiting the role of glucagon in health, diabetes mellitus and other metabolic diseases

This Review highlights mechanisms of glucagon secretion from pancreatic α-cells, including paracrine actions in islets and α-cell–β-cell crosstalk. Dysregulated glucagon secretion in metabolic diseases is also considered and the clinical potential of targeting glucagon is discussed.

• Sofie Hædersdal
• , Andreas Andersen
•  &  Tina Vilsbøll

Perspective | 13 March 2023

A perspective on treating type 1 diabetes mellitus before insulin is needed

This Perspective discusses potential approaches to managing patients in the early stages of developing type 1 diabetes mellitus, which could enable the initiation of insulin therapy to be delayed in some patients.

• Danijela Tatovic
• , Parth Narendran
•  &  Colin M. Dayan

Research Highlight | 10 March 2023

Interventions in people newly diagnosed with type 1 diabetes mellitus

Research Highlight | 07 March 2023

The metabolic benefits of exercise-induced hepatic autophagy

Journal Club | 02 March 2023

GLP1: the early steps of a success story

• Rula Bany Bakar

Research Highlight | 22 February 2023

Sulfonylurea secondary failure mechanism identified

Research Highlight | 13 February 2023

Serine slows diabetic neuropathy in mice

Browse broader subjects

• Endocrine system and metabolic diseases
• Metabolic diseases

Browse narrower subjects

• Diabetes complications
• Diabetes insipidus
• Gestational diabetes
• Type 1 diabetes
• Type 2 diabetes

Quick links

• Explore articles by subject
• Guide to authors
• Editorial policies

Changing our Future Through Research

The ADA is committed to innovation and breakthrough research that will improve the lives of all people living with diabetes.

ADA Research: Science. Progress. Hope.

ADA research provides critical funding for diabetes research. With 100% of donations directed to research, our goal is to ensure adequate financial resources to support innovative scientific discovery that will translate to life-changing treatments and eventual cures.

of our funded researchers remain dedicated to careers in diabetes science

publications per grant, cited an average of 28 times, proving expertise and credibility 

Every $1 the ADA invests in diabetes research leads to $12.47 in additional research funding

ADA Research Impact

Explore some of the latest innovations and discoveries and see how the ADA continues to advance science, leverage investments and retain scientists.

Research Funds at Work

Imagine what 290 scientists, each working on a unique project at 117 institutions across the U.S. can do. Learn about the research we fund to move the diabetes fight forward.

Helping People Thrive

Uncover inspiring patient stories and find out how our research is transforming lives.

Discover programs on research, career development, training, and more.

Learn more about the current opportunities for 2024 research funding. 

Pathway to Stop Diabetes ®

A bold initiative dedicated to bringing 100 brilliant scientists to diabetes research.

Explore Research Projects

As part of our mission, ADA’s Research Programs invest in projects that have the potential to prevent the development of diabetes and help people living with diabetes. 

Type 1 Diabetes Research

Project topics span technology, islet transplantation, immunology, improving transition to self-management, and more.

Type 2 Diabetes Research

Project topics include support for potential new treatments, a better understating of genetic factors, addressing disparities, and more.

Prediabetes/Insulin Resistance Research

Projects include understanding the role of exercise, novel therapies, and more.

Gestational Diabetes Research

Projects focus on advancing the prevention of gestational diabetes and to properly diagnose and treat it when it occurs.

Research on Obesity

Projects include studying the biology of appetite regulation and metabolism, identification of new treatment targets, and trials exploring interventions for weight loss.

Give Today and Change lives!

With your support, the American Diabetes Association® can continue our lifesaving work to make breakthroughs in research and provide people with the resources they need to fight diabetes.